肿瘤患者食欲评价和调节的专家共识

李增宁，李晓玲，陈伟，齐玉梅，胡雯，葛声，周春凌，杨雪锋，张片红，赖建强，焦广宇，胡怀东，高淑清，王晓琳，张勇胜，胡小翠，周莉，周岚，刘晓军，李莉，施万英，杨勤

doi:10.16689/j.cnki.cn11-9349/r.2020.02.007

肿瘤代谢与营养电子杂志 >

2020 , Vol. 7 >Issue 2: 169 - 177

DOI: https://doi.org/10.16689/j.cnki.cn11-9349/r.2020.02.007

共识、指南与标准

肿瘤患者食欲评价和调节的专家共识

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中国抗癌协会肿瘤营养专业委员会，中国医师协会营养医师专业委员会，中国医疗保健国际交流促进会营养与代谢管理专业委员会

网络出版日期: 2021-04-12

基金资助

河北省重点研发计划项目健康医疗与生物医药专项（182777127D）

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Expert consensus on appetite assessment and regulation in cancer patients

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Chinese Society for Oncological Nutrition and Supportive Care， Chinese Clinical Nutritionist Center， Speciality Committee of Nutrition and Metabolism Management of China International Exchange and Promotion Association for Medical and Healthcare

Online published: 2021-04-12

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摘要

食欲下降是肿瘤患者常见症状，癌性厌食/恶液质综合征在晚期肿瘤患者中发病率较高。肿瘤患者因营养摄入不足，会出现全血细胞减少、体重下降、脂肪组织和骨骼肌减少，导致患者免疫力降低，治疗耐受性下降，治疗机会减少，并发症增加，不利于抗肿瘤治疗措施的实施。准确评估癌性厌食的过程，无论对研究还是临床救治都极为重要，科学的食欲评价方法和技术不仅是营养工作者客观评价食欲的工具，也是进一步认识和预测营养不良的基础，对改善肿瘤患者营养不良具有积极意义。本共识根据国内外现有研究证据，对该领域的研究结果进行系统总结。从肿瘤、营养与食欲的关系出发，分析癌性厌食的发生发展机制，总结不同情况下肿瘤患者的食欲评价方法，并给出专家推荐意见。结合我国膳食现状和特点，从临床、营养、护理、中医的角度提出调节食欲的方法，科学规范癌性厌食管理策略，以便临床医师、临床营养专业人员、护士等医疗保健人员应用，更好地为肿瘤患者服务。

关键词： 肿瘤; 食欲; 厌食; 评价; 干预

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李增宁，李晓玲，陈伟，齐玉梅，胡雯，葛声，周春凌，杨雪锋，张片红，赖建强，焦广宇，胡怀东，高淑清，王晓琳，张勇胜，胡小翠，周莉，周岚，刘晓军，李莉，施万英，杨勤 . 肿瘤患者食欲评价和调节的专家共识[J]. 肿瘤代谢与营养电子杂志, 2020 , 7(2) : 169 -177 . DOI: 10.16689/j.cnki.cn11-9349/r.2020.02.007

Abstract

Loss of appetite is a common symptom in cancer patients， and the incidence of cancer anorexia cachexia syndrome is higher in advanced cancer patients. Due to insufficient nutrition intake， cancer patients will suffer from pancytopenia， weight loss， loss of fat tissue and skeletal muscle， resulting in decreased immunity， decreased treatment tolerance， reduced treatment opportunities， and increased complications. These problems are not conducive to the implementation of anti-cancer treatment measures. Accurate assessment of the process of cancer anorexia is of great importance for both research and clinical treatment. Scientific methods and techniques of appetite assessment are not only tools for nutritionists to evaluate appetite objectively， but also the basis for further understanding and prediction of malnutrition， which have positive significance for improving malnutrition in cancer patients. According to the existing research evidence， this consensus systematically summarized the research results in this field. Starting from the relationship between tumor， nutrition and appetite， this paper analyzed the mechanism of the occurrence and development of cancer anorexia. We summarized the evaluation methods of appetite in tumor patients under different conditions and gave expert recommendations. Combined with the status and characteristics of diet in China， this paper proposed the methods of improving appetite from the perspectives of clinical practice， nutrition， nursing and traditional Chinese medicine. We scientifically standardized the management strategy of cancer anorexia， so as to facilitate the application of clinicians， clinical nutrition professionals， nurses and other medical care personnel to better serve the cancer patients.

Key words： Cancer; Appetite; Anorexia; Evaluation; Intervention

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